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血液透析患者因……导致的导管相关血流感染

Catheter-Related Bloodstream Infection in Hemodialysis Patient due to .

作者信息

Hristova Preslava M, Alexandrova Alexandra S, Lucanov Martin, Hitkova Hristina Y, Borisov Biser Kirilov

机构信息

Department of Microbiology and Virology, Medical University - Pleven, Pleven, Bulgaria.

Department of Medical Microbiology, Medical University of Sofia, Sofia, Bulgaria.

出版信息

Case Rep Nephrol Dial. 2023 Sep 20;13(1):142-147. doi: 10.1159/000533581. eCollection 2023 Jan-Dec.

Abstract

, previously known as , is a rare causative agent of human infections. Several reports testify that the most frequently infected patients are immunosuppressed, especially those undergoing hemodialysis. A 34-year-old man with an end-stage renal disease complained of chills, fever, and general fatigue at the end of a regular hemodialysis session. The echocardiographic examination showed vegetation located on the dialysis catheter in the right atrium. Empirical therapy was initiated with intravenous gentamicin, and after the isolation of the agent, the treatment was continued with intravenous imipenem/cilastatin. The blood cultures and the tip of the replaced catheter were positive for , identified by Vitek 2 Compact. Verification of the automated identification was performed using 16S sequencing. The 16S sequence product was used to query the NCBI bacterial database and revealed 99.75% identity to that of strain CIP 103176 16S ribosomal RNA in the NCBI GenBank database. The antimicrobial susceptibility results revealed resistance to aminopenicillins and susceptibility to all other tested antimicrobials. To our knowledge, this is the first report of catheter-related vegetation with echocardiographic confirmation and the successful eradication of infection in a patient undergoing hemodialysis with imipenem/cilastatin.

摘要

以前称为 ,是人类感染的一种罕见病原体。几份报告证明,最常感染的患者是免疫抑制患者,尤其是那些正在接受血液透析的患者。一名患有终末期肾病的34岁男子在一次常规血液透析结束时抱怨发冷、发烧和全身乏力。超声心动图检查显示右心房的透析导管上有赘生物。开始经验性使用静脉注射庆大霉素治疗,在分离出病原体后,继续使用静脉注射亚胺培南/西司他丁治疗。血培养和更换导管的尖端对 通过Vitek 2 Compact鉴定为 呈阳性。使用16S测序对自动鉴定进行验证。16S序列产物用于查询NCBI细菌数据库,结果显示与NCBI GenBank数据库中 菌株CIP 103176的16S核糖体RNA有99.75%的同一性。抗菌药敏结果显示对氨基青霉素耐药,对所有其他测试抗菌药物敏感。据我们所知,这是第一份经超声心动图证实的导管相关赘生物以及使用亚胺培南/西司他丁成功根除血液透析患者 感染的报告。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3de8/10601877/bac99a1d4ce7/cnd-2023-0013-0001-533581_F01.jpg

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